Anterior cysts of the spine: a difficult differential diagnosis to amyotrophic lateral sclerosis

J Neurol. 2008 Nov;255(11):1662-9. doi: 10.1007/s00415-008-0951-2. Epub 2008 Jul 18.


We describe three patients referred to our ALS/MND clinic with suspected diagnosis of amyotrophic lateral sclerosis (ALS). The patients were all male, middle aged, and their initial symptoms were weakness and fasciculations in upper limb muscles. Results of clinical and electrophysiological examination in all cases were in accordance with possible ALS according to the revised El Escorial criteria. Other conditions mimicking ALS appeared to be excluded by extensive technical examinations and laboratory tests. Only repeated MRI examinations revealed anterior spinal cysts several years after symptom onset. This report intends to highlight this rare and difficult differential diagnosis of ALS and underlines the value of the revised El Escorial criteria in conjunction with electrophysiology to asses the certainty of the diagnosis ALS.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amyotrophic Lateral Sclerosis / diagnosis*
  • Amyotrophic Lateral Sclerosis / pathology
  • Bone Cysts / diagnosis*
  • Bone Cysts / pathology
  • Cervical Vertebrae* / pathology
  • Diagnosis, Differential
  • Electromyography
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurologic Examination
  • Spinal Cord / pathology
  • Transcranial Magnetic Stimulation